Late facial growth and continuous dentoalveolar eruption: Implications for optimal dental implant placement.

Abstract

After somatic growth ceases, craniofacial remodeling continues throughout adulthood, and teeth maintain a slow but persistent tendency to erupt. These ongoing skeletal and dental changes contribute to the progressive infraocclusion of dental implants. Our aim was to critically evaluate the evidence on late facial growth and continuous dentoalveolar eruption, and their implications for timing, risk assessment, and management of dental implants. A critical review of the current literature was conducted, focusing on longitudinal studies, clinical trials, and systematic reviews addressing residual facial bone remodeling, dentoalveolar eruption, and implant infraocclusion. Particular attention was given to patient-specific factors and patient-reported outcomes. Late craniofacial growth and continuous eruption of natural teeth contribute to spatial discrepancies between implants and adjacent dentition, even in skeletally mature adults. Younger age, increased anterior facial height, hyperdivergent facial patterns, and high smile lines were identified as key risk factors for implant infraocclusion. While delaying implant placement may reduce the risk of infraocclusion, there is no clear age threshold beyond which implants are entirely stable. Certain surgical techniques and prosthetic designs may mitigate long-term infraocclusion, and alternative treatments such as orthodontic space closure or adhesive bridges may provide a viable solution in selected cases. Progressive infraocclusion of implants is a multifactorial phenomenon influenced by residual craniofacial growth and alveolar changes. A thorough understanding of these biological processes and associated risk factors is essential to guide clinicians in selecting the optimal timing for implant placement and in considering alternative treatment strategies when appropriate. An evidence-based, patient-centered approach can help improve long-term functional and aesthetic outcomes, as well as patient satisfaction.